Longitudinal Associations Between Breakfast Consumption, Sleep Duration and Depressive Symptoms in Adolescents

Objectives: This study aimed to investigate the longitudinal associations between breakfast consumption, sleep duration and depressive symptoms among adolescents. Methods: The baseline survey (T1) was conducted from November to December 2019 using a multi-stage stratified cluster sampling method among secondary school students in Shanghai, China. The follow-up survey was conducted about one and a half years later (T2). A total of 2502 adolescents were included in the final analysis. Depressive symptoms were evaluated using the Chinese version of the Patient Health Questionnaire-2 (PHQ-2-C). Breakfast consumption frequency and sleep duration in the past week were self-reported. A cross-lagged model was constructed to examine the longitudinal associations between breakfast consumption, sleep duration and depressive symptoms. Results: The results showed that the prevalence of depressive symptoms and insufficient sleep increased from 15.31% and 89.53% at T1 to 18.47% and 92.89% at T2, respectively. The rate of daily breakfast consumption decreased from 81.10% to 76.06%. The cross-lagged model showed that daily breakfast consumption could significantly predict depressive symptoms (β = -0.109, SE = 0.030, p < 0.001) and sleep duration (β = 0.070, SE = 0.028, p = 0.013). Sleep duration could predict depressive symptoms (β = -0.076, SE = 0.022, p < 0.001) and vice versa (β = -0.039, SE = 0.018, p = 0.028). Conclusions: The rate of daily breakfast consumption among adolescents decreased, alongside the prevalence of depressive symptoms and insufficient sleep increased. Daily breakfast consumption predicted depressive symptoms and sleep duration, whereas depressive symptoms and sleep duration may have a bidirectional association.